Positioning retainer for oro-tracheal tubes



Jan. 21, 1958 J. w. PHILLIPS 2,820,457

POSITIONING RETAINER FOR ORO-TRACHEAL TUBES Filed Jan. 14. 1955 4 15 III,

INVENTOR.

ATTORNEY POSITIONING RETAINER FOR ORO-TRACHEAL TUBESv John W. Phillips,Olive View,,Calif.

Application January. 14, 1955, Serial No. 481,757

4 Claims. (CL 128351) Generally. speaking, the present invention:relates to anesthesia and similar therapeutic arts, having to do withthe throat and lungs; more particularly, it pertains to an improvedoro-tracheal tube positioning retainer adapted tioning independentlyasapositioner and guard structure 1 serving to protect the mouth andmedical (including anesthesia) apparatusintroduced therein from mutualdamage.

It is an object of the presentinvention to provide a novel oral (and/orbro-tracheal), tube positioner and retainer adapted to, prevent.compression and obstruction of the. tube by a patientsvteethv or. jaws;adapted to anchor the tube in a patientsmouth; adaptedto provideforquick and easy adjustment and maintenance of depth of the tube withrespect to a patientstrachea; and adapted to allow auxiliary access intoa patient s mouth.

It is a further object of the present invention to provide a novel oral,access port adapted to prevent compression and obstruction. of. a tube.by a patients teeth or jaws; adapted to prevent damage to saidteeth orjaws by said tube or other medical instrument (orpequipment); andadapted to allow auxiliary. accessto. the mouth. of the patient.

Other and allied objects will be apparent to thoseskilled in the artafter a careful perusahexamination and study of theaccompanying;illustrations, the present specification, and the appendedclaims.

To facilitate understanding, reference will be-made to the hereinbelowtdescribed drawings, in which:

Fig. 1 is aniexploded perspective view of one illustrative form of thepresent invention;

Fig. 2 is a longitudinal sectional view of thedevice shown in Fig. 1 infullyassembled relationship as itwould appear if viewed in thedirection.of. the arrows IIII in Fig. 1, the constricting ringbeing shown innon-en-- Fig. 4 is a-reducedesizetview,partly in section, showing.

the tube retainer ofa-the present invention. in retained relationshipwith respect to a .patients mouth, the constricting ring being inengaged relationship with respect to'the tube;

Fig. 5 is a reduced-sizeperspective view showing the tube'retainer ofthepresent invention in retained relationship with respect toapatientsmouth and showing the cooperative relationship of the strapmeans with respect to the patients head and with respect to thestrap-holding J nired States Patent it A ice 2 means as the strap holdsthe tube retainer firmly in position; and

Fig. 6 is a fragmentary view of a modified form of the mouth-insertionmember of the mouth-engaging means- (or oral access port) in which thediameter of the enlarged portion is enlarged in certain directions andis reduced in certain other directions.

It should be noted that all of the above described figures appear inupright position in the sheet of drawings.

This is merely for reasons of convenience and does not Generally speaking, the tube positioner and retainer of the present inventionincludes amouth-engaging member (or oral access port) having a projectingmouth-insertion member and a centrally apertured mouth-abutting flangemember positioned effectively across one end of saidinsertion member.Bore means extends through said mouth insertion member to the co-axial,larger diametered central aperture of said flange member and isadaptedto receive therethrough a hollow tube (usually a hollow flexibleoro-tracheal tube), or other medical instruments (such as abronchoscope, for example).

In the specific example illustrated, the mouth-insertion member isindicated generally at 1, the mouth-abuttingflange member is indicatedgenerally at 2, and the bore means isindicated generally at 3.

In the specific example illustrated, the projecting mouth-- insertionmember 1 comprises an enlarged portion 4 connected by a reduced-sizedneck 5 to the flange memberZ. This arrangement effectively providesmouth-retaining means on the mouth-insertion member, insertable betweenand retainable behind the upper and lower teeth 7 of the patient.

Also generally speaking, the tube retainer of the present inventionincludestan adjustable chuck in cooperable relationship with. respect tothe bore means and havingannular flat surface. means adjacent said boremeans, bushing means, constrictible engaging ring means, andselectively'manually advanceable ring-compressing means.

In the specific example illustrated, the annular fiat surface means 6surrounds the terminus of the bore means 3 and is positioned in thecentral aperture (indicated generally at A) of the flange means 2,serving with the cylindrical bushing 8 to contain the constrictible ringmeans 9 when in non-engaged position with respect to a tube, such as thetube 10 (as best shown in Fig. 2), and to hold the ring in position asit is constrictibly engaged with said tube (as best shown in Fig. 3).

in the specific example illustrated, the selectively manuallyadvanceablering-compressing means comprises a rotatable body member, indicatedgenerally at 11, cen trally apertured at 12 and provided with anexteriorly threaded cylindrical surface 13, engageable with a threadedportion 14 of the bushing. Lying about the central tube receivingaperture 12 is inclined annular inner surface means 15, which, withexterior surface 13, thus Said rim is forms a tapered ling-compressingrim. adapted to be inserted between said ring 9 and said bushing 8,being selectively positionable in any desired location between completeremoval and full ring-compressing insertion, by means of said threadedengagement of surface 13 with threaded surface 14-of the bushing. Inthis form of the invention, the constrictible ring means 9 comprises atoroidal spring.

The flange means 2 of the oral access port (or mouthengaging means) is,in the specific form illustrated, provided with lateral apertures B andwith strap holding means consisting of a pair of projecting studs 16.The access port is held firmly in position on the patients head by arubber strap 17 which is apertured in a plurality of locations 18 so asto be adjustably attachable to the strap holding studs 16.

In the modified form of the tube retainer illustrated in Fig. 6, thediameter of the mouth insertion member is reduced in certain directions,by a flat 19 (or diametrically opposed pair of flats), and themouth-engaging means is, for insertion purposes, placed so that saidflat is toward the teeththus insertion is facilitated; after insertion,the device is rotated until the normal-diameter portions of themouth-insertion member are engaged by the interior of the mouth, and theface conforming flange engages the exterior of the mouth. In this formof the invention the normal (non-flatted) diameter of the enlargedportion of the mouth-insertion member may be larger than in the form ofFigs. 1 through 5.

With reference to the flange means of Figs. 1 through 5, it should benoted that the height, with reference to the face, is considerably lessthan the width. It should also be noted that the radius of curvature ofthe flange in a vertical plane may be made greater than that in thehorizontal plane, if desired. In other words, the flange is soconstructed that it simulates the mouth portion of a face and may beplaced comfortably against virtually any normal face.

The operation of the device may be briefly described as follows: Theexploded components shown in Fig. l are assembled together in theposition shown in Fig. 2. Then the mouth-insertion member 1 is insertedthrough the upper and lower teeth 7, as shown in Fig. 4, and the flange2 is bound against the head by strap 17 as shown in Fig. 5. The tube isinserted to a desired depth and the ringcompressing member 11 isthreadedly advanced within the bushing 8 toward the annular flat surface6 so as to cause the inclined surface of the tapered rim to enterbetween the constricting ring 9 and the bushing 8, thus compressing thering 9 into fastening engagement with respect to the tube 10 (as bestshown in Fig. 3). The entire device will then be in operativerelationship with respect to the patients mouth and will maintain thetube 10 in a desired inserted relationship with respect to the patientstrachea and will allow the introduction of auxiliary apparatus into themouth through apertures B, if desired, and will further provide adequateprotection against occlusion of the tube 10 by the patients teeth 7 orinjury to the teeth or jaws by the tube.

Whenever it is desired to readjust the insertion depth of the tube 10,this can be done easily by merely threadedly retracting thering-compressing means 11 from the position shown in Fig. 3 into theposition shown in Fig. 2, then longitudinally readjusting tube 10, andthen threadedly advancing the ring-compressing means 11 into theposition shown in Fig. 3. One specific form of the subcombination of thepresent invention can be considered to be adequately illustrated (in onespecific embodiment) by the left member of the plurality of explodedmembers shown in Fig. 1, and comprises the mouth-insertion member 1, themouth abutting flange member 2, and the bore means 3also, thissubcombination form of the invention may include the strap 17, such asis shown in Fig. 6. This subcombination form of the invention,considered broadly, may be employed with a variety of different types oftube chucks, etc., other than the specific one described and illustratedherein.

Numerous modifications and variations of the present invention willoccur to those skilled in the art after careful study hereof. All suchproperly within the basic spirit and scope of the present invention areintended to be included and comprehended herein as fully as ifspecifically described, illustrated and claimed herein.

For example, the exact configurations of the mouthinsertion member, themouth-abutting flange member, the annular flat surface means, theconstrictible ring means,

, to permit the introduction of auxiliary-apparatus into the month orfor other ingress or egress purposes.

Furthermore, while the 'portionsof'the present invention, exclusive ofthe constrictible ring means, may preferably be made of a material suchas Lucite (acrylic resin), or other suitable material sufficientlystrong to support screw threads, and sufficiently resilient to precludedamage to a patients teeth (polyethylene plastic might be used,especially for the oral access port as a separate entity), various othermaterials or combinations of materials may be employed. i

It should also be noted that the constrictible ring means does notnecessarily take the form of a toroidal spring but may comprise anysuitable type of constrictible member capable of constrictiblecooperation with an annular inclined surface, or the equivalent.

The exact compositions, configurations, constructions, relativepositionings, and cooperative relationships of the various componentparts of the present invention are not critical, and can be modifiedsubstantially within the spirit of the present invention.

The embodiments of the present invention specifically described andillustrated herein are exemplary only, and are not intended to limit thescope of the present invention, which is to be interpreted in the lightof the prior art and the appended claims only, with due considerationfor the doctrine of equivalents.

I claim:

1. An oral tube positioning retainer comprising: mouth-engaging meansincluding external mouth-abutting flange means in which a centralaperture is defined, a projecting mouth-insertion member mounted on saidflange means and retainably engageable by the interior of the mouth, andbore means defined by said mouthinsertion member and connected to saidcentral aperture, through which a hollow tube may pass from the oralcavity to said central aperture of said flange means; saidmouth-abutting flange means being of a shape virtually complementary tothe facial structures adjacent to the lips, said flange means beingprovided with strap-holding means; a tube-chuck mounted in said centralaperture and including annular flat surface means and bushing meanscooperable with said flange means, constrictible ring means, andmanually advanceable ring-compressing means having a tube-receivingaperture and inclined annular inner surface means by which said ring maybe selectively gradually constricted as said inclined surface isforcibly inserted between said ring and said bushing means toward saidflat surface means, and by which said ring may be selectively graduallyreleased as said surface is moved away from said fiat surface means;said manually advanceable ring-compressing means being an annularcylindrical member screw-threadedly engageable with said bushing, saidflat annular surface means being positioned within said central aperturearound the connecting end of said bore means, and said constrictiblering means being a toroidal spring in slidable constrictiblerelationship with respect to said inclined surface means and inabuttingly retained relationship with respect to said fiat surface meanswhereby said hollow tube, when introduced through said central aperture,may be positioned and protected from the jaws and be selectivelyretained in fixed position or released as it is respectively engaged ordisengaged by said ring of said tube-chuck;

strap means attachable to said strap-holding means, by which the headmay be encompassed to hold said flange means firmly in position againstthe mouth.

2. An oral tube positioning retainer comprising: mouth-engaging meansincluding external mouth-abutting flange means in which a centralaperture is defined, a projecting mouth-insertion member mounted on saidflange means and retainably engageable by the interior of the mouth, andbore means defined by said mouthinsertion member and connected to saidcentral aperture, through which a hollow tube may pass from the oralcavity to said central aperture of said flange means; saidmouth-abutting flange means being doubly curved and of shape virtuallycomplementary to the facial structures adjacent to the lips, said flangemeans being comfortably placeable against the facial structures exteriorto and nearby the mouth, said flange means including a plurality oflateral aperture means to communicate with the mouth, and strap-holdingmeans; a tube-chuck mounted in said central aperture and includingannular flat surface means and bushing means cooperable with said flangemeans, constrictible ring means, and manually advanceablering-compressing means having a tubereceiving aperture and inclinedannular surface means by which said ring may be selectively graduallyconstricted as said inclined surface is forcibly inserted between saidring and said bushing means toward said flat surface means, and by whichsaid ring may be selectively gradually released as said surface is movedaway from said flat surface means; said manually advanceableringcompressing means being an annular cylindrical memberscrew-threadedly engageable with said bushing, said flat annular surfacemeans being positioned within said central aperture around theconnecting end of said bore means, and said constrictible ring meansbeing a toroidal spring in slidable constrictible relationship withrespect to said inclined surface means and in abuttingly retainedrelationship with respect to said flat surface means whereby said hollowtube, when introduced through said central aperture, may be positionedand protected from the jaws and be selectively retained in fixedposition or released as it is respectively engaged or disengaged by saidring of said tube-chuck; strap means attachable to said strap-holdingmeans, by which the head may be encompassed to hold said flange meansfirmly in position against the mouth.

3. An oral access port member serving to protect the front of the oralcavity and medical apparatus introduced therein from mutual damage,comprising: mouth-abutting flange means of shape virtually complementaryto the facial structures adjacent to the lips, said flange means beingprovided with a central aperture and with strapholding means; aninternal mouth-insertion member mounted on said flange means and shapedso as to be firmly retained by the relaxed jaws; and bore means definedby said mouth-insertion member to permit free communication between theoral cavity and said central aperture of said flange means, through aconstant-size opening; strap means attachable to said strap-holdingmeans, by which the head may be encompassed to hold said flange meansfirmly in position against the mouth.

4. An oral access port member serving to protect the front of the oralcavity and medical apparatus introduced therein from mutual damage,comprising: mouthabutting doubly curved flange means of shape virtuallycomplementary to the facial structures adjacent to the lips, said flangemeans being comfortably placeable against the facial structures exteriorto and nearby the mouth, said flange means defining a central aperture,a plurality of lateral aperture means to communicate with the mouth, andstrap-holding means; an internal mouthinsertion member mounted on saidflange means and shaped so as to be firmly retained by the relaxed jaws;and bore means defined by said mouth-insertion member to permit freecommunication between the oral cavity and said central aperture of saidflange means, through a constant-size opening; strap means attachable tosaid strap-holding means, by which the head may be encompassed to holdsaid flange means firmly in position against the mouth.

References Cited in the file of this patent UNITED STATES PATENTS

